What is Phantom Limb Pain?
Phantom limb pain (PLP) is the localized pain in the extremity following an amputation. Although there is no formal medical testing to diagnose symptoms, physicians rely ona patient’s history and symptoms to make a presumptive diagnosis. Research suggests that phantom pain originates in the spinal cord and the brain and can lead to chronic pain. Dr. Eldor Brish – an experienced pain physicianfrom Austin, Texas states that phantom limb pain may have an immediate onset or occur months to years after the amputation. Similarly, although pain management may be challenging, a combination of medication,therapy, and interventional procedures may help alleviate or minimize symptoms. He discusses the symptoms and treatment options for individuals who suffer from phantom limb pain.
Causes & Symptoms of PLP
Phantom pain is a neuropathic pain disorder that is perceived in the region of the amputated limb as abnormal often times uncomfortable and painful sensations. Studies suggest that an underlying cause of phantom limb pain may be due to the ‘rewiring’ of the brain post surgery. After an amputation the brain may form new neural connections due to a cessation of sensory information from the missing limb.
Many individuals who experience the phenomenon describe feeling as if the limb is still there. . This is different and not to be confused with stump pain. Characteristics of phantom limb pain include a stabbing, shooting, or throbbing sensations felt in the area of the amputated leg or arm. Individuals may often experience pain in the distal area of the missing limb such as the ankle or ball of the foot.
According to Dr. Eldor Brish, there are several risk factors which increase the likelihood of individuals developing phantom limb pain. Persistent stump pain due to nerve damage often results in increased nerve activity. Similarly, those who have consistent pain before amputation, may have a higher chance of experiencing phantom pain post-surgery.
According to Dr. Eldor Brish, phantom limb pain is unfortunately common amongst amputees, although the frequency and severity of the pain tends to vary amongst individuals. Although treatment can be challenging,there are several options available for pain management.
Mirror therapy (MT) is a non- pharmacological treatment method and has shown promising results in decreasing phantom limb pain. This type of pain modality uses a mirror to create a reflective illusion which can reduce pain in the amputated limb. A patient sits in front of a mirror with their phantom limb on the non-reflective side. Movements made with the normal limb reflect in the mirror; however, the brain perceives the movement as coming from the phantom limb. Other therapy methods include the use of acupuncture, electrical nerve stimulation, and virtual reality therapy.
There are several types of medication classes which can assist patients in treating and minimizing their symptoms including neuropathic analgesics whose mechanism acts directly on damaged nerves.
Finally, there are more advanced treatment options including sympathetic blocks and spinal cord stimulation.
Dr. Eldor Brish & Pain Management Dr. Eldor Brish specializes in pain management and has an extensive professional resume. Per Dr. Brish, there phantom limb pain has diverse treatment possibilities which fortunately can assist patients continue to maintain an active functional lifestyle.